@article {Grimshaw416, author = {JM Grimshaw and Noah Ivers and Stefanie Linklater and Robbie Foy and Jill J Francis and Wouter T Gude and Sylvia J Hysong}, editor = {, and , and Alderson, Sarah and Boet, Sylvain and Brehaut, Jamie and Brown, Benjamin and Clarkson, Jan and Colquhoun, Heather and Keizer, Nicolette de and Desveaux, Laura and Dobell, Gail and Dunn, Sandra and Farrin, Amanda and Foy, Robbie C and Francis, Jill J and Greenberg, Anna and Grimshaw, Jeremy M and Gude, Wouter T and Hartley, Suzanne and Horsley, Tanya and Hysong, Sylvia J and Ivers, Noah M and Landis-Lewis, Zach and Linklater, Stefanie and London, Jane and Lorencatto, Fabiana and Michie, Susan and O{\textquoteright}Connor, Denise and Peek, Niels and Presseau, Justin and Ramsay, Craig and Sales, Anne E and Sprague, Ann and Stanworth, Simon and Sykes, Michael and Taljaard, Monica and Thavorn, Kednapa and Walker, Mark and Walwyn, Rebecaa and Weiss, Debra and Willis, Thomas A and Witteman, Holly}, title = {Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback}, volume = {28}, number = {5}, pages = {416--423}, year = {2019}, doi = {10.1136/bmjqs-2018-008355}, publisher = {BMJ Publishing Group Ltd}, abstract = {Audit and feedback (A\&F) is a commonly used quality improvement (QI) approach. A Cochrane review indicates that A\&F is generally effective and leads to modest improvements in professional practice but with considerable variation in the observed effects. While we have some understanding of factors that enhance the effects of A\&F, further research needs to explore when A\&F is most likely to be effective and how to optimise it. To do this, we need to move away from two-arm trials of A\&F compared with control in favour of head-to-head trials of different ways of providing A\&F. This paper describes implementation laboratories involving collaborations between healthcare organisations providing A\&F at scale, and researchers, to embed head-to-head trials into routine QI programmes. This can improve effectiveness while producing generalisable knowledge about how to optimise A\&F. We also describe an international meta-laboratory that aims to maximise cross-laboratory learning and facilitate coordination of A\&F research.}, issn = {2044-5415}, URL = {https://qualitysafety.bmj.com/content/28/5/416}, eprint = {https://qualitysafety.bmj.com/content/28/5/416.full.pdf}, journal = {BMJ Quality \& Safety} }